Tuberculosis in solid organ transplant candidates and recipients

Subramanian, Aruna

doi:10.1097/qco.0000000000000082

Cited by 23 publications

(22 citation statements)

References 43 publications

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“…TB diagnosis may be challenging due to the presence of immunosuppression, low sensitivity and reproducibility of tests used to diagnose latent TB infection before transplant, and the potential for atypical presentation [25]. …”

Section: Discussionmentioning

confidence: 99%

Tuberculosis Patients Who Are A Potential Source for Unprotected Exposure in Health Care Systems: A Multicenter Case Control Study

Cadena

Castro-Pena

Javeri

et al. 2017

Open Forum Infectious Diseases

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SettingFive health care systems in Texas.ObjectiveTo describe the epidemiology of inadequate isolation for pulmonary tuberculosis leading to tuberculosis (TB) exposures from confirmed TB patients and the patient factors that led to the exposures.DesignA retrospective cohort and case-control study of adult patients with TB resulting in exposures (cases) vs those TB patients who did not result in exposures (controls) during January 2005 to December 2012.ResultsThere were 335 patients with pulmonary TB disease, 199 cases and 136 controls. There was no difference between groups in age (46 ± 14.6 vs 45 ± 17 years; P > .05), race, or substance abuse. Cases were more likely to be transplant recipients (adjusted odds ratio [AOR], 18.90; 95% CI, 1.9–187.76), have typical TB chest radiograph (AOR, 2.23; 95% CI, 1.1–4.51), and have positive acid-fast bacilli stains (AOR, 2.36; 95% CI, 1.31–4.27). Cases were less likely to have extrapulmonary disease (AOR, 0.47; 95% CI, 0.24–0.95).ConclusionsTB exposure resulting from inadequate isolation is frequent in health care settings. Extrapulmonary involvement resulted in earlier airborne isolation. Being a transplant recipient, having chest radiograph findings typical for TB, and sputum positivity acid-fast bacilli upon staining were associated with increased risk of inadequate isolation.

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Section: Discussionmentioning

confidence: 99%

Tuberculosis Patients Who Are A Potential Source for Unprotected Exposure in Health Care Systems: A Multicenter Case Control Study

Cadena

Castro-Pena

Javeri

et al. 2017

Open Forum Infectious Diseases

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“…Le patient transplanté rénal a un risque accru d’infection par les mycobactéries à cause du traitement immunosuppresseur qui altère la fonction de cytotoxicité des lymphocytes T, principal effecteur immunitaire contre ce type de germes [ 3 ]. La prévalence de la tuberculose chez le transplanté varie de 0.3 à 15% reflétant ainsi la variation de la l’incidence de la tuberculose chez la population générale dans chaque région [ 3 - 4 ]. Dans les pays d’endémie tuberculeuse, comme le Maroc, la fréquence de la tuberculose chez le transplanté rénal est 20 à 70% plus élevée par rapport à la population générale [ 1 ].…”

Section: Discussionunclassified

“…L’IDR à la tuberculine doit être réalisée chez tout candidat à la transplantation d’organe pour dépister une tuberculose latente, elle doit être refaite 15 jours plus tard si elle est négative [ 8 ]. Elle est considérée positive si l’induration est-supérieure ou égale à 5mm [ 4 ]. Le test de libération de l’interféron gamma peut être utile dans le dépistage de la tuberculose latente en cas de négativité de l’IDR à la tuberculine, cependant son rôle n’est pas établi chez la population des dialysés [ 4 ].…”

Section: Discussionunclassified

Une spondylodiscite tuberculeuse chez une transplantée rénale compliquée d’une mycosesystémique

et al. 2014

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En transplantation, les complications infectieuses sont fréquentes et de diagnostic souvent délicat. Elles peuvent coexister chez le transplanté rénal rendant leur diagnostic encore plus difficile. Le but de ce cas clinique est de discuter les difficultés diagnostiques et de surveillance de deux types de pathologies assez fréquentes chez le transplanté rénal, qui sont la tuberculose et la mycose, à travers l’observation clinique d’une patiente de 24 ans transplantée rénale qui présente une spondylodiscite tuberculeuse et qui développe secondairement une septicémie à Candida non albicans à point de départ urinaire dont le seul point d’appel est la fièvre post opératoire.

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“…5,11 Donor-derived disease transmission is rare, complicating less than 1% of transplants. [23][24][25] Based on their radiologic findings, the basic mechanism in our 10 SOT recipients with TB could be reactivation of latent TB. However, the cause was not clear for the rest of the patients because they had neither prior history of TB nor radiologic findings.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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Objectives: Tuberculosis remains an important problem in solid-organ transplant patients due to their immunocompromised state. The objective of the present study was to report the incidence, demographic characteristics, and various presentations of tuberculosis in solid-organ transplant recipients. were diagnosed with tuberculosis. The majority of patients (85%) were diagnosed with tuberculosis within 6 months after transplant, and 15% were diagnosed within 3 months. Most diagnoses of tuberculosis were based on histopathologic examination of biopsy material. Of these patients, 9 were diagnosed with pulmonary tuberculosis, 8 had extrapulmonary tuberculosis, and 2 had both. Nontuberculosis mycobacteria infections were detected in 3 patients. Conclusions:Even with a negative exposure history, tuberculosis can manifest as different clinic presentations in solid-organ transplant patients on immunosuppressive drugs, particularly in the first 6 months after transplant. Therefore, clinicians should always consider tuberculosis as the potential cause of an infectious disease with unknown cause to successfully diagnose and manage solid-organ transplant recipients.

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Tuberculosis in solid organ transplant candidates and recipients

Cited by 23 publications

References 43 publications

Tuberculosis Patients Who Are A Potential Source for Unprotected Exposure in Health Care Systems: A Multicenter Case Control Study

Tuberculosis Patients Who Are A Potential Source for Unprotected Exposure in Health Care Systems: A Multicenter Case Control Study

Une spondylodiscite tuberculeuse chez une transplantée rénale compliquée d’une mycosesystémique

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